Plantar Fasciitis: Understanding the Condition and Available Treatments

Plantar fasciitis is a common condition that affects the bottom of the foot, specifically the heel and the arch. It is caused by inflammation of the plantar fascia, a band of tissue that runs from the heel to the toes and provides support to the arch of the foot. This condition can cause significant pain and discomfort and can be a hindrance to daily activities and physical activity.

Symptoms of plantar fasciitis include pain in the heel and bottom of the foot, especially when first standing up in the morning or after sitting for long periods. Pain may also increase after physical activity, such as walking or running. The pain is often described as a dull ache or sharp pain and can be accompanied by swelling in the affected area.

There are several factors that may contribute to the development of plantar fasciitis, including:

  1. Overuse: Engaging in physical activity, especially high-impact sports, can put excessive stress on the plantar fascia and lead to inflammation.
  2. Age: As we age, the plantar fascia may become less flexible, making it more susceptible to injury.
  3. Foot structure: Foot problems such as flat feet, high arches, and overpronation (when the foot rolls inward when walking) can increase the risk of developing plantar fasciitis.
  4. Obesity: Excessive weight can put added stress on the plantar fascia, leading to inflammation and pain.
  5. Occupation: Jobs that require prolonged standing or walking on hard surfaces can also increase the risk of developing plantar fasciitis.

Diagnosing plantar fasciitis is typically done through a physical examination of the foot and a review of the patient’s medical history. In some cases, imaging tests such as X-rays or MRI scans may be ordered to rule out other conditions and to get a clearer picture of the extent of the injury.

There are several non-surgical treatment options available for plantar fasciitis, including:

  1. Stretching exercises: Stretching the calf muscles, plantar fascia, and Achilles tendon can help alleviate pain and prevent further injury. Stretching should be done regularly, especially before and after physical activity.
  2. Ice therapy: Applying ice to the affected area for 15-20 minutes at a time can help reduce swelling and pain.
  3. Orthotics: Custom orthotics, or shoe inserts, can be prescribed to help provide support and cushioning to the foot and alleviate pain.
  4. Medications: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help reduce pain and swelling. In severe cases, a prescription-strength nonsteroidal anti-inflammatory drug (NSAID) may be prescribed.
  5. Physical therapy: Physical therapy can help improve flexibility and strength in the foot and ankle, reducing the risk of further injury.

In cases where conservative treatments are not effective, surgical intervention may be necessary. Surgical options for plantar fasciitis include gastrocnemius fascial release, in which the fascia of the back of the leg is lengthened. This is done endoscopically through two small stab incisions. This allows the tension on the fascia to be relaxed, relieving the pain. It is important to seek medical attention as soon as possible if you are experiencing pain in the heel and bottom of the foot. Early treatment can help prevent further injury and speed up the healing process. Your foot and ankle surgeon can recommend the best course of treatment for your individual needs and evaluate your condition for further management.